Functional outcomes following fenestration discectomy for lumbar disc prolapse: a tertiary care center study from north india

Background: Lumbar disc herniation causes low back pain and radiculopathy, often leading to significant functional impairment. Fenestration discectomy remains a widely practiced surgical technique, particularly in resource-limited settings, owing to its simplicity and cost-effectiveness. Aim: To evaluate the functional outcomes of fenestration discectomy in patients with lumbar disc prolapse using the Japanese Orthopaedic Association (JOA) Low Back Pain Score. Materials and Methods: This prospective interventional study was carried out at a tertiary care centre in North India over a one-year period. Twenty-four patients aged 20–59 years with single-level lumbar disc prolapse and unilateral radiculopathy, unresponsive to at least eight weeks of conservative treatment, were included. All patients underwent fenestration discectomy and were followed for six months. Functional outcomes were assessed using the JOA score. Results: The mean preoperative JOA score improved from 8.75 to 14.3 at final follow-up, with a mean recovery rate of 88.8%. Excellent outcomes were observed in 45.8% of patients, good in 41.7%, and fair in 12.5%. Fifteen patients (62.5%) returned to their pre-symptomatic activity level. Complications included postoperative discitis in one patient (4.2%) and intraoperative dural tear in two patients (8.3%), all managed successfully. Conclusion: Fenestration discectomy provides favorable functional outcomes with low complication rates and remains a safe, effective, and economical surgical option for lumbar disc prolapse, especially in developing countries.